The Need for our Work
Studies of the general population have shown that the support of an experienced birth companion can improve outcomes for both mothers and babies. Findings suggest that women who receive continuous labour support are more likely to give birth vaginally, need fewer interventions and have higher satisfaction rates and slightly shorter labours. A study in a Texas hospital focused on a group of low-income women comparable to the women we support. This study found highly improved outcomes for mothers and babies who were supported by a birth companion compared with the control group who were without this support. Very little research exists into the impact that birth, antenatal and postnatal support has on the physical and mental health outcomes of mothers and babies in prison and there is a real need for research in this area.
Midwives working with women in Holloway report that their pregnancies are more complex and high-risk. A UK study showed that women in prison are less healthy than the most socially disadvantaged women in the community. Some women may actually experience improved health when they come to prison but they are still more likely to have difficult pregnancies because of high stress levels, existing physical and mental health issues, and previous experience of abuse and violence, substance misuse and homelessness.
Pregnancy can be a difficult time for women in the community but there are additional challenges for women in prison who are often anxious and uncertain about their future. Some women only discover they are pregnant when tested on entry to prison: they may be on remand and have not yet been to court, so they do not know if they will be in prison for the birth.
Quite often, women do not know if they will get a place on the Mother and Baby Unit if they are still in prison and they worry about how being in prison might affect their baby. They are also likely to worry about how their partner, siblings and wider family will bond with the new baby. As well as concerns about their unborn baby, most pregnant women are separated from children they were caring for in the community and will feel anxious about how these children are coping. Additionally, pregnant women are often concerned about what will happen at the hospital with handcuffing and officers, and whether their family will arrive in time for the birth.
Some may have no one to be with them during labour: their partner might also be in prison, their mother may be caring for their other children and family and friends may live far away from the prison. Generally, women receive far less visits and support than men in prison. It is therefore unsurprising that pregnant women in prison regularly describe feeling stressed, anxious and unsafe.